| NPI | 1578062030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH DEEDS Owner 931-551-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2018-02-09 |